Phyllis Dawson, Psy.D., LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PHYLLIS DAWSON, PSY.D., LLC

Practice address

666 Dundee Rd Ste 1302
Northbrook, IL 60062-2736

Phone

(224) 326-0025

Fax

(847) 400-5828

NPI assigned

Sep 4, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Phyllis Dawson, PSY.D.NPI 1346258449

Title

Clinical Psychologist

Phone

(224) 326-0025

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phyllis Dawson, PSY.D.

  • Clinical Psychologist
  • Northbrook, IL
  • NPI 1346258449
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1063061984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD STE 1302",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622736",
            "telephone_number": "224-326-0025",
            "fax_number": "847-400-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD STE 1302",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622736",
            "telephone_number": "224-326-0025",
            "fax_number": "847-400-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYLLIS DAWSON, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "224-326-0025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.